From the Research
Stroke patients typically do not exhibit bilateral manifestation of the Asymmetric Tonic Neck Reflex (ATNR), with the reflex generally appearing unilaterally on the hemiplegic or paretic side affected by the stroke. The ATNR in stroke patients can re-emerge following brain damage, particularly when there is injury to the frontal lobe or corticospinal tracts 1. In stroke patients, when the head is turned to one side, the arm and leg on the side to which the face is turned may extend, while the opposite limbs flex - but this response is typically only observed on the affected side of the body.
The unilateral nature of ATNR in stroke reflects the localized brain damage that characterizes stroke pathology. Key points to consider include:
- The presence and severity of ATNR can serve as a prognostic indicator for recovery, with stronger manifestations often correlating with poorer functional outcomes 1.
- Clinicians should assess for ATNR during neurological examinations of stroke patients as its presence can impact rehabilitation strategies and may require specific interventions to manage abnormal tone and posturing.
- Studies have shown that the effect of ATNR is significant in the stroke population, especially during dynamic conditions such as reaching movements 2.
- The use of botulinum toxin type A may be an important adjunctive therapy to increase the therapeutic effect of other treatments on spasticity in stroke patients 3, 4.
Overall, the ATNR is an important consideration in the management and rehabilitation of stroke patients, and its presence and severity can have significant implications for patient outcomes.